Loss of Libido – An Overview

Loss of libido (↓ sexual desire) is a common but often hidden concern in primary care. It refers to a persistent or recurrent reduction in sexual interest that causes personal distress or relationship difficulties.

Although medically defined within DSM-5 as:

Hypoactive Sexual Desire Disorder (HSDD) – in men
Female Sexual Interest/Arousal Disorder (FSIAD) – in women

...GPs typically use the broader, patient-friendly term “low libido.”

Why it Matters in UK General Practice

Common: ~15% of men, 34% of women (16–74 yrs) report ↓ interest in sex (Natsal-3, 2013) [1].
Under-discussed: Many affected patients never raise it—GPs must be ready to ask sensitively.
Multifactorial Causes:
- Biological: Endocrine disorders, chronic illness, medications
- Psychological: Depression, anxiety, past trauma
- Social: Relationship issues, cultural beliefs

Key Causes of Loss of Libido

Category	Males	Females
Biological	↓ Testosterone (e.g. hypogonadism) Chronic illness (DM, CVD) Medication (SSRIs, β-blockers) Obesity Thyroid dysfunction	Hormonal changes (↓ estrogen, menopause, postpartum) Chronic illness (DM, CVD) Medication (SSRIs, OCPs) Thyroid dysfunction Pregnancy, breastfeeding
Psychological	Stress, anxiety Depression Low self-esteem, poor body image Relationship issues Performance anxiety	Stress, anxiety Depression Low self-esteem, poor body image Relationship issues Trauma or abuse history
Social/Cultural	Masculinity pressures Work-life imbalance Cultural/religious beliefs Aging concerns...

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